腹腔镜保守手术联合GnRH-a对子宫内膜异位症患者卵巢功能及妊娠率影响研究  

Study on the effect of laparoscopic conservative surgery combined with GnRH-a on ovarian function and pregnancy rate in patients with endometriosis

作　　者：徐小敏 江秀秀[2] 林俊[2] XU Xiao-min;JIANG Xiu-xiu;LIN Jun(The Quzhou Affiliated Hospital of Wenzhou Medical University(Quzhou People’s Hospital Quzhou),Zhejiang 324100,China;不详)

机构地区：[1]温州医科大学附属衢州医院(衢州市人民医院)妇科,浙江衢州324000 [2]浙江大学医学院附属妇产科医院,浙江杭州310006

出　　处：《中国实用妇科与产科杂志》2021年第7期786-789,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金(81370694)。

摘　　要：目的探讨腹腔镜保守手术联合促性腺激素释放激素激动剂(GnRH-a)对子宫内膜异位症(内异症)患者卵巢功能及妊娠率的影响。方法选择浙江大学医学院附属妇产科医院于2018年10月至2019年3月收治的98例内异症Ⅲ期以上患者为研究对象,采用随机数字表法分为对照组和观察组各49例。对照组给予腹腔镜保守手术治疗,术后不予药物治疗;观察组给予腹腔镜保守手术联合GnRH-a治疗。比较两组术后3个月血清炎性因子、基础内分泌及术后12个月复发率和妊娠率。结果治疗3个月时,观察组血清白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)、血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平明显低于对照组(P<0.05);术后12个月观察组有效率、妊娠率明显高于对照组(95.9%vs.79.6%和85.7%vs.40.8%),复发率明显低于对照组(4.1%vs.20.4%)(均P<0.05)。结论腹腔镜保守手术联合GnRH-a有助于下调内异症患者血清炎性因子水平,保护卵巢功能,提高妊娠率,降低复发率。Objective To investigate the influence of the laparoscopic surgery combined with GnRH-a on ovarian function and pregnancy rate of patients with endometriosis.Methods The 98 cases of endometriosis patients of stage Ⅲ and above admitted to Women’s Hospital,School of Medicine,Zhejiang University,from October 2016 to March 2017 were selected as the research subjects,and were randomly divided into control group and observation group,with 49 cases each.The control group underwent laparoscopic conservative surgery and no medication was given after surgery.The observation group underwent laparoscopic conservative surgery combined with GnRH-a treatment.Serum inflammatory factor and basal endocrine in 3 months after operation were compared between the two groups.Recurrence rate and pregnancy rate in 12 months after operation were compared between the two groups.Results After 3 months of treatment,the levels of serum interleukin 6(IL-6),interleukin 8(IL-8),and tumor necrosis factor alpha(TNF alpha)in the observation group were significantly lower than those in the control group(P<0.05),and the levels of serum follicle stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)were significantly lower than those in the control group(P<0.05);effective rate and pregnancy rate in the observation group were obviously higher than those in the control group,while the recurrence rate was obviously lower than that in the control group(95.9%vs.79.6%,85.7%vs.40.82%,4.1%vs.20.4%,P<0.05).Conclusion Laparoscopic conservative surgery combined with GnRH-a helps to lower the level of serum inflammatory factors,protect the ovarian function,improve the pregnancy rate and reduce the recurrence rate in patients with endometriosis.

关 键 词：子宫内膜异位症 促性腺激素释放激素激动剂 炎性介质 卵巢功能 妊娠率 

分 类 号：R711.71[医药卫生—妇产科学]